How Do I Find a Great Elder Law Attorney?

Elder law attorneys specialize in legal affairs that uniquely concern seniors and their adult children, says Explosion’s recent article entitled “The Complete Guide on How to Find an Elder Law Attorney.”

Finding the right elder law attorney can be a big task. However, with the right tips, you can find an experienced elder law attorney who is knowledgeable, has the right connections and fits your budget.

While, technically, a general practice attorney will be able to handle your retirement, Medicaid and even your estate planning, an elder law lawyer is deeply entrenched in elder law. This means he or she will have extensive knowledge and experience to handle any case within the scope of elder law, like the following:

  • Retirement planning
  • Long-term care planning and insurance
  • Medicaid
  • Estate planning
  • Social Security
  • Veterans’ benefits; and
  • Other related areas of law.

While a general practice lawyer may be able to help you with one or two of these areas, a competent elder law lawyer knows that there’s no single formula in elder law that applies across the board. That’s why you’ll need a lawyer with a high level of specialization and understanding to handle your specific circumstances. An elder law attorney is best suited for your specific needs.

A referral from someone you trust is a great place to start. When conducting your elder law lawyer search, stay away from attorneys who charge for their services by the hour. For example, if you need an elder law attorney to work on a Medicaid issue, they should be able to give you an estimate of the charges after reviewing your case. That one-time flat fee will cover everything, including any legal costs, phone calls, meetings and court fees.

When it comes to elder law attorneys, nothing says more than experience. An experienced elder law lawyer has handled many cases similar to yours and understands how to proceed. Reviewing the lawyer’s credentials at the state bar website is a great place to start to make sure the lawyer in question is licensed. The website also has information on any previous ethical violations.

In your search for an elder law attorney, look for a good fit and a high level of comfort. Elder law is a complex area of law that requires knowledge and experience.

Reference: Explosion (Aug. 19, 2020) “The Complete Guide on How to Find an Elder Law Attorney”

Why are Medicare Scams Increasing in the COVID-19 Pandemic?

Medicare scams are increasing in the COVID-19 pandemic. Motley Fool’s recent article entitled “Seniors, Be Wary of These Medicare Scams During COVID-19” discusses some red flags you should look out for to avoid being a victim.

  1. Callers requesting your Medicare number. Medicare typically won’t call beneficiaries and randomly ask them to verify their benefits. If someone calls you and requests your Medicare ID number, don’t give them your information.
  2. Callers requesting your Social Security number. If a bad guy gets your Social Security number, he can do a number of things with that information, any of which will create headaches for you. This includes opening a credit card in your name and charging a lot of expenses on it. If you get a caller who says he’s a Medicare representative who needs your Social Security number to process a health claim, don’t give it to him.
  3. Email or phone calls asking you to send money. Medicare doesn’t sell prescriptions over the phone or ask seniors to pre-pay for services. If someone calls asking you to send money or give out credit card information, it’s a bogus caller.
  4. A promise for early access to a COVID-19 treatment or vaccine. Right now, there is no COVID-19 vaccine. There is also no mail-order treatment that you can stock up on to protect yourself in case you’re struck with the virus. Therefore, don’t believe a caller who says he’s from Medicare and is offering you a chance to get in on a groundbreaking medication. Don’t pay him or share your Medicare ID number during that conversation. When an effective vaccine is available, Medicare will pay for it and let you know how to get it.
  5. Someone at your door claiming to be from Medicare. Medicare doesn’t have sales reps. Therefore, if someone says they’re from Medicare, lock the door and demand that that person leave immediately. Call the police, if you need help.

When a lot of seniors are worried, isolated, and in financial straits, they don’t need to fall victim to a scam. Be prepared and be aware of what common fraud attempts look like. That way, you’ll be in a good position to protect yourself.

If you receive a suspicious email or phone call, report it at 1-800-MEDICARE. This might prevent another senior from falling victim to what could be an extremely dangerous trap.

Reference: Motley Fool (May 25, 2020) “Seniors, Be Wary of These Medicare Scams During COVID-19”

How Do I Talk about End-Of-Life Decisions?

With the coronavirus pandemic motivating people to think about what they prioritize in their lives, experts say you should also take the time to determine your own end-of-life plans.

Queens News Service’s recent article entitled “How to have the hardest conversation: Making end-of-life decisions” reports that in this coronavirus pandemic, some people are getting scared and are realizing that they don’t have a will. They also haven’t considered what would happen, if they became extremely ill.

They now can realize that this is something that could have an impact upon them.

According to the U.S. Centers for Disease Control and Prevention (CDC), 70% of Americans say they’d prefer to die at home, while 70% of people die in a hospital, nursing home, or a long-term care facility. This emphasizes the importance of discussing end-of-life plans with family members.

According to a survey of Californians taken by the state Health Care Foundation, although 60% of people say that not burdening their loved ones with extremely tough decisions is important, 56% have failed to talk to them about their final wishes.

“Difficult as they may be, these conversations are essential,” says American Bar Foundation (ABF) Research Professor Susan P. Shapiro, who authored In Speaking for the Dying: Life-and-Death Decisions in Intensive Care.

“Now is a good time to provide loved ones with the information, reassurance and trust they need to make decisions,” Shapiro says.

Odds are the only person who knows your body as well as you do, is your doctor.

When thinking about your end-of-life plans, talk with your doctor and see what kind of insight she or he can provide. They’ve certainly had experience with other older patients.

If you want to make certain your wishes are carried out as you intend, detail all of your plans in writing. That way it will be very clear what your loved ones should do, if a decision needs to be made. This will eliminate some stress in a very stressful situation.

Even after the COVID-19 pandemic is over, everyone will still need a will.

Talk with an experienced elder law or estate planning attorney to make certain that you have all of the necessary legal documents for end-of-life decisions.

Reference: Queens News Service (May 22, 2020) “How to have the hardest conversation: Making end-of-life decisions”

Medicare Patients Be Wary of COVID-19 Scams!

It’s still not easy to get tested for COVID-19 in many states, so it’s not surprising to learn that scammers are exploiting the shortage. They’re especially preying on the elderly.

Money Talks News’ recent article entitled “Are You on Medicare? Beware Coronavirus Scammers” reports that scammers use stolen personal data to commit Medicare fraud and identity theft, according to the U.S. Department of Health and Human Services.

Medicare warned beneficiaries in a recent email, “Unfortunately, scammers are using the COVID-19 pandemic to try to steal your Medicare number, personal information and money. And they’re using robocalls, social media posts and emails to do it.”

Some of these criminals are even knocking on people’s doors to talk them out of their personal data.

Seniors are advised to not divulge their personal information, including their Medicare number, with anyone, except a trusted health care provider or other qualified expert. If you’re unsure who’s legitimate, call for help and advice from your Senior Medicare Patrol, volunteer groups funded by the Department of Health and Human Services (HHS).

Health and Human Services says that your personal information can be used to fraudulently bill federal health care programs and commit medical identity theft.

You may also wind up being responsible for charges, if Medicare denies the claim for an unapproved test. You need to protect your Medicare and Social Security information, because it can be used in fraud schemes. If you think you’ve been contacted by a scammer, do the following:

  • Report suspected criminals to the National Center for Disaster Fraud Hotline at 866-720-5721 or write to disaster@leo.gov.
  • Be on guard, if someone requests your Medicare number, when you didn’t ask for services.
  • Be suspicious of those offering coronavirus supplies or testing.
  • When using social media, don’t click or respond to advertisements and offers for coronavirus testing.
  • If you think you should get a COVID-19 test, ask your doctor or doctor’s office.

In addition, the FBI advises everyone — not only seniors — to be aware of and to report:

  • Bogus emails purporting to be from the Centers for Disease Control and Prevention (CDC).
  • Phishing emails, which try to trick you into sharing personal information.
  • Counterfeit treatments and equipment, like sanitizing products, masks, face shields, goggles, respirators, protective gloves or gowns.

Reference: Money Talks News (May 19, 2020) “Are You on Medicare? Beware Coronavirus Scammers”

When will Social Security Stimulus Checks Arrive?

There have been a few hiccups in the distribution of stimulus checks, and some people may have to wait months before their check is delivered. Most of us are able to monitor the status of our check by using the IRS’s Get My Payment tool. However, for many Social Security beneficiaries, they’ll see a message that says “Payment Status Not Available.” That’s because most Social Security recipients don’t file tax returns.

Motley Fool’s ’s recent article entitled “Social Security Beneficiaries: Here’s When You’ll Get Your Stimulus Check” advises that if you are unable to track your payment, here’s when you can expect to receive your stimulus money if you’re collecting Social Security benefits.

Those first to see their stimulus checks will be the ones who have their direct deposit information on file with the IRS. The agency will deposit the stimulus check straight to their bank account.

However, if you receive your benefits in the mail via paper check, or if you’re not certain if your bank account information is on file, you can provide your information through the Get My Payment tool. This will help you get your check faster.

While using direct deposit will ensure you get your check the quickest, you can get your check in the mail instead if your bank account info isn’t on file. The IRS started sending stimulus checks the week of April 20, and it expects to mail out about five million checks per week. At that rate, it could take 20 weeks for all checks to be delivered.

Whether you receive your check in days or months will depend on your income. The IRS is sending checks in a particular order, and those with the lowest-income individuals will get their checks first. If your income is nearer to the $99,000 per year income limit (or $198,000 per year for married couples), you might not receive your check until late August or early September.

If your income is somewhere in the middle, it’s estimated that you’ll get your check sometime this summer.

If you’re receiving Supplemental Security Income (SSI), you’ll see your stimulus payment in early May, according to the IRS. Whether you receive that money via direct deposit or paper check will be based on whether the IRS has your bank account information on file.

The COVID-19 pandemic has caused a real financial hardship for millions of Americans, and waiting for your stimulus check can be stressful, especially if money is tight and you need the extra money. However, it’s a little easier when you can at least calculate when your cash is expected to be delivered.

Reference: Motley Fool (April 27, 2020) “Social Security Beneficiaries: Here’s When You’ll Get Your Stimulus Check”

Is Long-Term Care Insurance Really a Good Idea?

Forbes’ recent article entitled “Is Long-Term Care Insurance Right For You?” says that a big drawback for many, is the fact that LTCI is expensive. However, think about the costs of long-term care. For example, the current median annual cost for assisted living is $43,539, and for a private room in a nursing home, it’s more than $92,000.

Another issue is that there’s no way to accurately determine if in fact you’ll even need long-term care. Much of it depends on your own health and family history. However, planning for the possibility is key.

Remember that Medicare and other types of health insurance don’t cover most of the cost of long-term care—what are known as “activities of daily living,” like bathing, dressing, eating, using the bathroom and moving. Medicare will only pay for medically necessary skilled nursing and home care, such as giving shots and changing dressings and not assisted-living costs, like bathing and eating. Supplemental insurance policies generally don’t pay for this type of care.

Those with a low net worth might qualify for long-term care provided under Medicaid.

Shop around, because policies and prices are different. Check the policy terms and be sure you understand:

  • The things that are covered, such as skilled nursing, custodial care, and assisted living
  • If Alzheimer’s disease is covered as it’s a leading reason for needing long-term care
  • If there are any limitations on pre-existing conditions.
  • The maximum payouts
  • If the payments are adjusted for inflation
  • The lag time until benefits begin
  • How long benefits will last
  • If there’s a waiver of premium benefit, which suspends premiums when you are collecting long-term care benefits
  • If there’s a non-forfeiture benefit, which offers limited coverage even if you cancel the policy
  • If the current premiums are guaranteed in future years, or if there are limits on future increases
  • How many times rates have increased in the past 10 years
  • If you purchase a group policy through an employer, see if it is portable (if you can take it with you if you change jobs).

Typically, when you are between 50 to 65 is the most cost-effective time to buy LTCI, if you’re in good health. The younger you buy, the lower the cost. However, you will be paying premiums longer. Premiums usually increase as you get older and less healthy. There’s a possibility that you’ll be denied coverage, if your health becomes poor. Therefore, while it’s not inexpensive, buying LTCI sooner rather than later may be the best move.

Reference: Forbes (April 17, 2020) “Is Long-Term Care Insurance Right For You?”

How Do We Test for Dementia?

“Unfortunately, there is not one single test that confirms dementia while you are alive,” says Dr. Julie Brody Magid, clinical director of the Harvard-affiliated McLean Hospital Memory Disorders Assessment Clinic. “The testing process is multilayered and takes many things into consideration. Going through this evaluation may help identify memory problems, before they get worse.”

An article in the upcoming May issue of Harvard Men’s Health Watch entitled “Testing for dementia” explains that the symptoms of dementia include memory loss, problem-solving difficulties and language issues. The author says that behavior and emotions also can be impacted. The symptoms are often subtle in the early stages and then get progressively worse. These symptoms can continue to interfere with daily life tasks, such as remembering to attend appointments, taking your medications, or paying bills. Dementia patients also may have trouble preparing meals or driving safely.

The most common kind of dementia is Alzheimer’s. Its symptoms include having a hard time retaining recently acquired information and remembering recent conversations. Those with Alzheimer’s disease  may also have difficulty monitoring upcoming events and may make repetitive comments.

A physician can begin a dementia screening with a brief test, like the Mini-Mental Status Exam or the Montreal Cognitive Assessment. These take about 10 minutes and include tasks, such as learning a list of words and then recalling them minutes later and identifying the similarities between words. Your doctor will determine if your screening test score and symptoms warrant more testing. If so, she will refer you to a memory clinic for a full assessment, which includes a neuropsychological evaluation and biomarker tests.

The neuropsychological evaluation lasts about four hours. It includes a series of in-depth analyses, such as one-on-one interviews and written and oral tests, designed to gauge specific cognitive functions, like attention, problem solving, spatial skills and executive functioning. These test scores are compared with what an average person of the same age and education level may experience.

Biomarker tests may include an MRI to look for structural changes in the brain, like small lesions or changes in the white matter. This may show damage to brain tissue, due to small strokes and suggest that memory issues may be related to vascular disease or “vascular dementia.” This scan also can show shrinkage of the cortex (the area that processes memory, attention and problem solving) or less volume in the hippocampus (the region involved in short- and long-term memory). While there’s some amount of brain shrinkage with normal aging, significant changes in brain volume may mean a higher probability of early Alzheimer’s.

Once your doctor reviews everything, and if a cognitive disorder is confirmed, it is categorized as mild, moderate, or severe, which will help the doctor prescribe the best available treatments.

If Alzheimer’s is suspected, there are prescription drugs that can help retard symptom progression. If the diagnosis is vascular dementia, it’s important to manage cardiovascular risk factors such as taking medications to control blood pressure and cholesterol levels, exercising regularly and following a heart-healthy diet.

With memory loss, you must be as proactive as with any other health issue. The more you delay in taking action, the fewer tools that are available.

Reference: Harvard Men’s Health Watch (May 2020) “Testing for dementia”

What Should I Ask, If My Mom Is in a Quarantined Facility

Federal guidance for nursing homes state that members of the public and non-essential health care personnel and staff shouldn’t be permitted to visit (with a few exceptions, such as an end-of-life situation — as long as the visitor isn’t showing signs of a respiratory illness), according to guidelines from the Centers for Medicare & Medicaid Services.

AARP’s recent article entitled “6 Questions to Ask if Your Loved One Is in a Quarantined Facility” explains that assisted living communities are a different situation, because they’re governed by the states. As a result, there have been no broad rules covering their management during the outbreak. However, the American Health Care Association/National Center for Assisted Living, an industry trade group, is advocating that its facilities to follow the federal government’s guidance for nursing homes.

To ease the anxiety, many of these residences are making great efforts to communicate with family members, such as emails, phone calls and websites, outlining their policies and instructions for connecting with residents and posting photos of residents’ daily activities.

However, many family members are still worried about how their loved ones are doing, when they can’t confirm their well-being first-hand person. Therefore, if you have questions about their care, you need to be assertive. Be firm, polite and persistent. Here are some questions that you might ask, if your loved one is in a quarantined facility:

  1. Has anyone at the facility tested positive for COVID-19? Nursing homes and long-term care facilities have been hard hit by COVID-19, so ask about testing of all staff members, residents and any vendors who service the facility.
  2. How are you keeping the facility clean and keeping the risk of infection low for residents? Ask about the protocols put into place to protect the patients. This should include screening staff who are caring for your parents, and what are they doing to keep the place sanitized.
  3. Is the facility maintaining regular healthy-living programs? The patients need to have services, like physical therapy and occupational therapy programs designed to keep your loved one from deconditioning.
  4. How are the residents being engaged? Are there activities, like games, presentations and music to keep the residents engaged?
  5. How do I communicate with my parent? Some facilities have set up visits via Skype, WhatsApp and FaceTime between families and their loved ones.
  6. How is the facility working with drop-off deliveries? You may want to deliver something like flowers or baked goods for dad at the care facility, so find out the procedure.

Reference: AARP (April 15, 2020) “6 Questions to Ask if Your Loved One Is in a Quarantined Facility”

Caring for Alzheimer’s and Dementia Patients during Stay-At-Home Orders

The Havre Daily News’ recent article entitled  “Alzheimer’s Association offers tips for keeping people with dementia engaged during stay-at-home orders” reported that, to help caregivers engage their family members suffering from Alzheimer’s and other dementia, the Alzheimer’s Association has provided some ideas to assist.

Alzheimer’s disease is a progressive disorder that causes brain cells to degenerate and die. This disease is the most common cause of dementia, which is defined as a continuous decline in thinking, as well as behavioral and social skills that disrupts a person’s ability to function independently.

When considering how to help a person with dementia stay engaged during the pandemic, the release from the Alzheimer’s Association said, you can start by asking yourself these questions:

  • What do they like to do?
  • What are they able to do?
  • What are they in the mood for today?

The Alzheimer’s Association says that spending time with a family member or loved one with Alzheimer’s and other dementia can still be a meaningful and fun experience, especially if you take your cue from them. Let’s look at some ideas:

Encourage involvement in daily life activities. These types of basic activities can help the person feel like a valued part of the household. This can be things like setting the table and folding laundry. The tasks can give a dementia patient a sense of success and accomplishment.

Be ready to adjust and modify activities. Some activities that the person enjoys may need to be changed or modified, because of the stay-at-home orders in effect in most states. A few ideas are low-impact at-home workout videos; playing games like checkers, cards, or board games; or looking at photo albums.

Concentrate on individual enjoyment. Someone who’s worked in an office might enjoy activities that involve organizing, such as collating papers, putting coins in a holder, or creating a to-do list. A former farmer or gardener may like being in the fresh air and working in the yard.

Don’t be afraid to request help. Ask family members and friends for help with some non-contact chores. This might include help putting the trash out, collecting the mail, or tending to the yard. You should also look into meal and grocery delivery services.

The Alzheimer’s Association now has free expanded educational programs via telephone and online. These programs provide crucial information about Alzheimer’s and related dementias, effective communication techniques, understanding and responding to dementia-related behaviors and more.

There are also additional resources for caregivers on the association’s website at https://www.alz.org.

Reference: Havre Daily News (April 14, 2020) “Alzheimer’s Association offers tips for keeping people with dementia engaged during stay-at-home orders”

Do I Really Need a Health Care Proxy?

The Pauls Valley Democrat’s recent article entitled “Advance directives and living wills” explains that an Advance Directive has three parts:

  • A living will
  • Naming of your health care agent; and
  • Your directions for anatomical gifts.

The individual that you name as your Health Care Proxy will make decisions for your treatment and care, if you’re unable to do so. These decisions may extend to all medical issues and aren’t limited to end-stage, life determining decisions that are mentioned in your living will. This is a form of power of attorney that authorizes your agent to act in your behalf to address issues like these:

  1. Accessing your medical information
  2. Discussing your treatment options with your healthcare providers
  3. Getting second opinions on your diagnosis
  4. Selecting and authorizing various medical tests
  5. Your placement in a hospital or care facility
  6. Transferring your care to a new physician; and
  7. Communicating your wishes on life support in terminal or unconscious situations.

For end of life decisions, your health care proxy is bound by your written wishes as expressed in your living will. Life support can be terminated, only if you so authorize in writing. Your healthcare proxy can’t make that decision for you, because that is “personal” to you. You may select one or more persons to act as your proxy, although if two are selected, you should predefine what to do in the event of a conflict.

A best practice is to choose a person who’s younger than you who is geographically close, a person with time to assist you and with whom you’re willing to share in advance your wishes, likes and dislikes as to medical care. This person should be trusted to act and honor your wishes.

Because many decisions relate to your very personal concerns about religion, death and dying, these feelings should be shared with your health care proxy before any serious situation.

The Advance Directive is a very important document that pertains to your wishes, as they relate to medical care, end-of-life and death.

Parts I and II can discuss your wishes for care treatment, as well as your choice of a person to represent your wishes. These are two very important issues. Take the time to consider the advance written expression of your own wishes.

Reference: Pauls Valley Democrat (Feb. 12, 2020) “Advance directives and living wills”